PCN reports : psychiatry and clinical neurosciences最新文献

{"title":"A new viewpoint on psychiatry: Supporting children's diversified \"ibasho\".","authors":"Tsubasa Sasaki, Yoshiyuki Hirano","doi":"10.1002/pcn5.70361","DOIUrl":"10.1002/pcn5.70361","url":null,"abstract":"","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 2","pages":"e70361"},"PeriodicalIF":1.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avoidant/restrictive food intake disorder complicated by superior mesenteric artery syndrome in an adolescent male with Klinefelter syndrome: A case report.","authors":"Kohei Kamikawa, Ryohei Takada, Yuya Honda, Harue Goto, Takashi Okada","doi":"10.1002/pcn5.70356","DOIUrl":"10.1002/pcn5.70356","url":null,"abstract":"<p><strong>Background: </strong>Avoidant/restrictive food intake disorder (ARFID) is characterized by restrictive or avoidant eating not driven by weight or shape concerns and is often associated with autism spectrum disorder (ASD). Superior mesenteric artery (SMA) syndrome may occur in ARFID with significant weight loss; however, overlapping gastrointestinal symptoms may obscure its recognition.</p><p><strong>Case presentation: </strong>A 16-year-old boy with a history of ASD and Klinefelter syndrome (47,XXY) presented with postprandial nausea, abdominal pain, fatigue, and rapid weight loss. He had chronic sensory hypersensitivity-related selective eating since early childhood and maintained a slender body habitus. Upon admission, his height and weight were 182 cm and 40.7 kg, respectively (body mass index [BMI] = 12.3). He had no drive for thinness, fear of weight gain, or body image disturbance and was diagnosed with ARFID. Abdominal ultrasonography revealed marked narrowing of the SMA-aorta angle (6.8°) and distance (3 mm), with duodenal compression, consistent with SMA syndrome. Enteral nutrition was initiated and gradually increased, accompanied by psychoeducation, meal support tailored to sensory sensitivities, and behavioral interventions. He showed weight restoration and improvement in gastrointestinal symptoms and duodenal obstruction, allowing a gradual transition to oral intake. Upon discharge, his weight was 49.0 kg (BMI = 14.8). Follow-up ultrasonography revealed partial improvement in the SMA-aorta angle.</p><p><strong>Conclusion: </strong>SMA syndrome should be considered in patients with ARFID who present with gastrointestinal symptoms and rapid weight loss. Klinefelter syndrome may increase vulnerability to SMA syndrome, complicating clinical recognition. Combining nutritional rehabilitation, medical evaluation, and psychosocial interventions is important for effective complex eating disorder management.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 2","pages":"e70356"},"PeriodicalIF":1.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine-learning classification of bipolar disorder incorporating wearable-derived core body temperature and actigraphy-derived sleep indices.","authors":"Kazuhiro Kurihara, Ayano Shiroma, Masaki Kamata, Naruyo Yoshimoto, Ayano Saso, Akiyoshi Shimura, Yukiko Imai, Tadashi Miyahara, Yoshikazu Takaesu","doi":"10.1002/pcn5.70359","DOIUrl":"10.1002/pcn5.70359","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to classify patients with bipolar disorder (BD) and normal controls (NCs) using machine-learning models that incorporate wearable-derived core body temperature (CBT) and actigraphy-derived sleep indices.</p><p><strong>Methods: </strong>We enrolled 23 euthymic patients with BD and 43 NCs. Sleep parameters were collected via wrist actigraphy for 14 days, and CBT was measured with a wearable device for 3 days to estimate the CBT nadir and its phase differences with sleep indices. Models were constructed with a base model using CBT- and sleep-derived features, and an extended model that included sociodemographic variables. Features were standardized (StandardScaler), and classifiers (random forest, LightGBM, and XGBoost) were evaluated. Hyperparameters were optimized using cross-validation within the training data. Performance was evaluated using repeated nested cross-validation. SHapley Additive exPlanations (SHAP) values were computed in the extended model to quantify relative feature contributions to the model output.</p><p><strong>Results: </strong>In nested cross-validation at the MaxF1 operating point, the mean area under the receiver operating characteristic curve (ROC-AUC) was 0.771 ± 0.162 for the base model and 0.930 ± 0.050 for the extended model. In the extended model, SHAP suggested that total sleep time, wake time, and the wake time-CBT nadir phase difference were features potentially associated with the model output.</p><p><strong>Conclusion: </strong>In this small-sample study, a classification approach combining wearable-derived CBT indices and actigraphy-based sleep parameters suggested preliminary discrimination between BD and NC. Further validation is warranted in larger cohorts with balanced background characteristics, including disorders requiring differential diagnosis.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 2","pages":"e70359"},"PeriodicalIF":1.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relaxation of Japan's clozapine monitoring system is urgently needed: Adding 10,000 future prescriptions may prevent up to 400 schizophrenia-related suicides and cost 1 death by agranulocytosis.","authors":"Jose de Leon, Yuki Kikuchi, Norio Yasui-Furukori","doi":"10.1002/pcn5.70357","DOIUrl":"10.1002/pcn5.70357","url":null,"abstract":"","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 2","pages":"e70357"},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research needs of caregivers of people with 22q11.2 deletion syndrome in Japan: A qualitative analysis.","authors":"Akiko Kanehara, Miho Tanaka, Yousuke Kumakura, Ryo Morishima, Yutaka Sawai, Yusuke Takahashi, Sho Yagishita, Seiichiro Jinde, Kiyoto Kasai","doi":"10.1002/pcn5.70352","DOIUrl":"10.1002/pcn5.70352","url":null,"abstract":"","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 2","pages":"e70352"},"PeriodicalIF":1.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Help-seeking anxiety, psychological distress, and suicidal ideation among medical and nursing students: A cross-sectional study.","authors":"Kentaro Kawabe, Yu Matsumoto, Yasutaka Ihara, Fumie Horiuchi","doi":"10.1002/pcn5.70353","DOIUrl":"10.1002/pcn5.70353","url":null,"abstract":"<p><strong>Aim: </strong>Suicide among young adults has become a serious public health concern. In Japan, suicide is a leading cause of death among adolescents and young adults. Suicidal ideation is a clinically meaningful psychological burden among young adults. However, the associations of suicidal ideation with help-seeking anxiety, psychological distress, and subjective well-being among healthcare students have not been explored sufficiently. This study aimed to examine the cross-sectional associations of help-seeking anxiety, psychological distress, and subjective well-being with suicidal ideation among first-year healthcare students.</p><p><strong>Methods: </strong>A cross-sectional web-based survey was conducted among 142 first-year medical and nursing university students in Japan. Suicidal ideation was assessed using the Suicidal Ideation Questionnaire, psychological distress was assessed using the Kessler Psychological Distress Scale, subjective well-being was assessed using the World Health Organization 5-item Well-Being Index (WHO-5), and help-seeking anxiety was assessed using the Thoughts About Therapy Survey. Associations among help-seeking anxiety, psychological distress, subjective well-being, and suicidal ideation were examined using Spearman's correlation analysis and multivariable regression analyses.</p><p><strong>Results: </strong>Higher help-seeking anxiety was associated with higher levels of suicidal ideation and psychological distress. Psychological distress was also associated with suicidal ideation, whereas subjective well-being was not clearly associated with suicidal ideation. In the multivariable regression analyses, help-seeking anxiety remained associated with suicidal ideation after accounting for psychological distress and subjective well-being. Additionally, most students reported having someone to consult when experiencing distress; however, awareness of university mental health services was limited.</p><p><strong>Conclusion: </strong>These findings highlight suicidal ideation as a clinically meaningful psychological burden among first-year healthcare students and suggest that psychological distress and help-seeking anxiety are associated with suicidal ideation.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 2","pages":"e70353"},"PeriodicalIF":1.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between adverse childhood experiences and over-the-counter drug abuse in Japan: A nationwide population-based cross-sectional study.","authors":"Yuhei Mori, Takashi Yoshioka, Risa Shishido, Mizuki Hino, Akiko Sato, Atsuko Nagaoka, Masataka Hatano, Yuto Hosogai, Kazusa Miyahara, Takahiro Tabuchi, Itaru Miura, Yasuto Kunii","doi":"10.1002/pcn5.70354","DOIUrl":"10.1002/pcn5.70354","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to examine the association between adverse childhood experiences (ACEs) and habitual over-the-counter (OTC) drug abuse in a nationwide Japanese population and determine whether this association varies with other substance use behaviors.</p><p><strong>Methods: </strong>We analyzed nationwide cross-sectional data and used multivariable logistic regression to estimate adjusted odds ratios (aORs) for the association between ACEs and OTC drug abuse. We also examined whether this association varied by other addictive behaviors, including habitual use of combustible cigarettes, electronic cigarettes (e-cigarettes), heated tobacco products (HTPs), alcohol, or illicit drugs.</p><p><strong>Results: </strong>We analyzed 25,424 adults from the 2025 Japan Society and New Tobacco Internet Survey (Feb 23 to Mar 31, 2025). Habitual OTC drug abuse prevalence was 6.8% (95% confidence interval [CI]: 6.2-7.4). Individuals with high ACE exposure had significantly higher odds of OTC drug abuse than those with lower ACE exposure (aOR = 3.18, 95% CI: 2.47-4.10, <i>p</i> < 0.001). The association was particularly strong among users of e-cigarettes (aOR = 27.14, 95% CI: 13.12-56.14) and HTPs (aOR = 6.88, 95% CI: 4.21-11.24). However, no significant interaction was observed among participants reporting illicit drug use (<i>p</i> = 0.14).</p><p><strong>Conclusion: </strong>ACEs were independently associated with habitual OTC drug abuse in this study. Similar associations were observed among individuals with other addictive behaviors, with higher odds indicating potential overlap in vulnerability pathways. These findings underscore the lasting impact of childhood adversity and the need for trauma-informed strategies to prevent emerging substance abuse.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 2","pages":"e70354"},"PeriodicalIF":1.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clozapine-induced diarrhea: A case report and mechanistic overview.","authors":"Shahab Dastmardi, Soha Namazi","doi":"10.1002/pcn5.70318","DOIUrl":"10.1002/pcn5.70318","url":null,"abstract":"<p><strong>Background: </strong>Clozapine is an atypical antipsychotic that is highly effective in managing treatment-resistant schizophrenia. However, its use is associated with a wide range of adverse effects, including agranulocytosis, seizures, sedation, and gastrointestinal issues such as constipation, and less commonly, diarrhea. While constipation is a well-documented side effect of clozapine, diarrhea induced by the drug remains underreported and poorly understood.</p><p><strong>Case presentation: </strong>A 46-year-old male patient with treatment-resistant schizophrenia developed severe diarrhea, fever, and weight loss shortly after initiating clozapine at a dose of 100 mg three times daily (300 mg/day). These symptoms persisted until clozapine was discontinued, after which they resolved. When clozapine was reintroduced, the symptoms of diarrhea recurred, confirming that clozapine was the causative agent of the gastrointestinal distress. The patient's clinical condition improved once clozapine was discontinued again, highlighting the potential for severe gastrointestinal adverse effects associated with this medication.</p><p><strong>Conclusion: </strong>Clozapine remains a valuable treatment option for individuals with treatment-resistant schizophrenia, but clinicians should be aware of its potential to cause severe gastrointestinal adverse effects, including diarrhea. Early recognition of these side effects, appropriate diagnostic evaluation, and timely management are essential to ensure patient safety and optimize treatment outcomes. In cases where gastrointestinal symptoms are severe, discontinuation of clozapine may be necessary to resolve the issues and prevent further complications.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 2","pages":"e70318"},"PeriodicalIF":1.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of mental health needs following the 2024 Noto Peninsula Earthquake: Comparison with the 2016 Kumamoto Earthquake.","authors":"Yoshifumi Takagi, Sho Takahashi, Tatsuhiko Kubo, Yasuhisa Fukuo, Sayaka Gomei, Chie Yaguchi, Tetsuaki Arai, Hirokazu Tachikawa","doi":"10.1002/pcn5.70336","DOIUrl":"10.1002/pcn5.70336","url":null,"abstract":"<p><strong>Aim: </strong>This study characterized Disaster Psychiatric Assistance Team (DPAT)-recorded consultations following the 2024 Noto Peninsula Earthquake (NPE) by comparing Japan Surveillance in Post Extreme Emergencies and Disasters (J-SPEED) records with Disaster Mental Health Information Support System (DMHISS) records from the 2016 Kumamoto Earthquake (KE), with particular attention to population aging, peninsula geography, geographic isolation, and infrastructure disruption.</p><p><strong>Methods: </strong>This descriptive epidemiological study analyzed J-SPEED data from the NPE (January 2 to May 26, 2024) and DMHISS data for the KE (April 14 to June 30, 2016). Age group, sex, consultation period, and mental health events were compared. Temporal comparisons were restricted to the common 78-day DPAT activity window. <i>p</i> values for 15 comparable event categories were adjusted using the Holm-Bonferroni method.</p><p><strong>Results: </strong>Consultations were fewer after the NPE (<i>n</i> = 488) than after the KE (<i>n</i> = 2,125), but among consultations with recorded age data, the proportion of older adults (65+ years) was higher after the NPE (58.4% vs. 41.4%). Anxiety (42.4%) and insomnia (32.8%) were the most frequent symptoms. After Holm-Bonferroni adjustment, depression, suicidal ideation, flashbacks, anger, excitement, incontinent speech, wandering, and verbal/physical aggression were more frequent after the NPE, whereas somatic symptoms were more frequent after the KE. Consultation timing within 78 days did not differ significantly, and consultations and deployments on or after Day 79 occurred only after the NPE.</p><p><strong>Conclusion: </strong>The NPE was characterized by a higher proportion of older adults and more frequent depression, suicidal ideation, flashbacks, and behavioral problems. Records on or after Day 79 indicate DPAT-involved consultations in a later post-disaster phase, although persistent needs and delayed reach of support could not be distinguished.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 2","pages":"e70336"},"PeriodicalIF":1.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The intermediate role of impulsive personality traits between attention-deficit/hyperactivity disorder symptoms and suicidal ideation among patients with schizophrenia.","authors":"Feten Fekih-Romdhane, Jaweher Zaouali, Ameni Barketi, Farah Ghrissi, Majda Cheour, Souheil Hallit","doi":"10.1002/pcn5.70350","DOIUrl":"10.1002/pcn5.70350","url":null,"abstract":"<p><strong>Aim: </strong>While there is a general consensus on Attention-Deficit/Hyperactivity Disorder (ADHD) serving as a possible suicide risk factor in a broad range of populations, scant research has been dedicated to addressing ADHD and suicidality in schizophrenia. Therefore, there is a pressing need for studies that clarify these connections within the context of schizophrenia. This study was designed as one of the first to explore how impulsivity may serve as an indirect mediator of the impact of ADHD symptoms on suicidal ideation in patients with schizophrenia.</p><p><strong>Methods: </strong>This study has a cross-sectional design and was performed between January and June 2025 among Tunisian outpatients with clinically stabilized chronic schizophrenia.</p><p><strong>Results: </strong>16.9% reported a lifetime personal history of suicidal attempt(s) and 11.3% a lifetime history of self-harm. Impulsivity partially mediated the association between ADHD symptoms and suicidal ideation (indirect effect: Beta = 0.127; Boot SE = 0.033; Boot CI: 0.069; 0.196). Higher ADHD symptoms were significantly associated with greater impulsivity and directly associated with higher suicidal ideation. Additionally, higher impulsivity was significantly associated with higher suicidal ideation.</p><p><strong>Conclusion: </strong>The present results stress the importance of paying more attention to the expression of impulsive personality traits in patients with schizophrenia who exhibit prominent ADHD symptoms and suicidal ideation.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 2","pages":"e70350"},"PeriodicalIF":1.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}